Accessory Saphenous Vein: A special tributary of the saphenous vein which often runs parallel to the saphenous vein, superficial to it, and towards the front (anterior) or back (posterior) of the thigh and terminates near the saphenofemoral junction at the groin.
Acute: An acute condition or acute stage of a condition refers to rapid onset, short course, or both. In medicine, it is usually a measure of time scale of a condition.
Ambulatory Microphlebectomy: The removal of varicose veins on an outpatient basis, usually done in the office using local anesthesia. Unlike traditional vein stripping, the procedure is done with a minimally invasive technique using a special dissecting hook and a series of 2-3 mm. (1/10th inch) skin punctures. Usually no sutures are required. It is also known as stab avulsion phlebectomy.
Anterior: The front of the body or body part.
Artery: The blood vessels of the circulatory system that carry oxygen rich blood away from the heart to the tissues.
Baker Cyst: A collection of fluid behind the knee joint associated with conditions if the joint such as arthritis or injury, relevant to phlebology only in that it may be noted incidentally during ultrasound examination.
Blood Vessel: An artery or vein that is part of the circulatory system.
Catheter: A thin tube made from medical grade materials which can be inserted into a body cavity or blood vessel to inject or drain substances. In phlebology, catheters are often used in veins to perform minimally invasive ablation treatments for varicose veins.
Chronic: A measure of time or scale of a condition, lasting a longer time, as opposed to acute.
Chronic Venous Insufficiency (CVI); Also known as Chronic Venous Disorder (CVD): A progressive medical condition that may worsen over time. Vein walls and valves are weakened and damaged, leading to a high pressure system in the vessels which carry blood back to the heart. Symptoms and signs include pain, swelling, and fatigue of the legs, and skin damage and ulcers, or sores, may occur. CVI is often preceded by varicose veins.
Circulation: The movement of fluid through the body in a regular or circuitous course. The circulatory system, composed of the heart and blood vessels, functions to deliver with oxygen and nutrients to the tissues, and then return it to the heart and lungs for another cycle. The venous circulation involves the return pathway.
Competent Vein: A vein in which blood flow occurs in the proper direction back to the heart, without excess pressure (also referred to as having “normal flow” or “no reflux”).
Compression Pump: An automated device using intermittent pneumatic compression, which aids in the treatment of edema. It may also be used to prevent clotting, for example, during surgery.
Compression Stockings: Also known as compression hose, these garments are used to treat chronic venous insufficiency and are often worn following varicose vein treatments. They may be prescribed by a physician and are individually fitted to the patient. They come in knee-high, thigh-high, and pantyhose styles and can help alleviate the swelling and pain associated with varicose veins. Some lower weight compression stockings can be purchased over the counter or online from specialty stores.
Congenital Venous Anomaly: Sometimes the venous system fails to develop normally, resulting in abnormalities termed congenital venous anomalies or malformations. Those affecting the lower extremities may be familial (inherited), or sporadic (a consequence of chance abnormal development), and may be associated with other findings elsewhere. The most common syndrome affecting the lower extremities is known as Klippel-Trenaunay syndrome.
Continuous Wave Doppler: An older form of diagnostic evaluation using a hand-held device that generates ultrasound waves and emits an audible signal indicating the velocity of blood flow. It has largely been replaced by more sophisticated techniques.
Deep Veins: Veins that lie within the groups of muscles or their lining, close to the bones, and carry blood back to the heart.
Deep Vein Thrombosis (DVT) (Thrombophlebitis): A condition that occurs when a blood clot forms in a deep vein, usually of the leg. It may become life threatening if the clot breaks off and moves to the lungs. A chronic condition affecting the legs known as post-phlebitic syndrome may also result as a consequence. DVT typically occurs with extended periods of inactivity such as after surgery or extended travel such as a long flight. One may also be predisposed to DVT by inherited conditions, injury, trauma and cancer, and certain medications.
Duplex Ultrasound Test: Currently, this is the mainstay of diagnostic tests for venous disorders. It uses ultrasound waves to measure directional speed of blood flow and also produces an image of structures. In this way, it provides the doctor with a map of the veins as well as an indication of valve competency, obstruction, clot, or other conditions that may be causing a venous disorder. It is also used as a guide during the performance of procedures such as endovenous ablation and ultrasound guided sclerotherapy.
Edema: The accumulation of fluid in the tissues, which may be seen in the lower legs of patients with varicose veins and chronic venous insufficiency, as well as other medical conditions.
Endovenous: Within a vein.
Endovenous Ablation: Closure of a vein from the inside, most often referring to the truncal (saphenous) veins of the lower extremity. A catheter is inserted into the vein and energy (most commonly thermal energy using laser or radiofrequency) is precisely applied to seal it shut. Blood is rerouted to more properly functioning veins. The treated vein dries up, shrinks, and is absorbed by the body. Sclerotherapy is also a form of endovenous ablation where a chemical is used to destroy the vein lining and cause it to shut down.
Foam/Foam Sclerotherapy: Sclerotherapy performed with a mixture of liquid and gas to create foam resulting in greater surface area and longer contact time with the inside lining of the affected vein.
Femoral Vein: The major deep vein of the lower extremity from the knee to the groin.
Great Saphenous Vein: A long vein that travels along the inside of the leg from the ankle to the thigh and empties into the femoral vein at the groin. It is a common source of valvular incompetence and venous insufficiency.
Hyperpigmentation: Skin discoloration, usually brownish, in the lower legs, which may be associated with chronic venous insufficiency.
Incompetent Vein: A vein with poorly functioning valves, so that blood flows in the wrong direction, or excess pressure is required for blood to proceed to the heart; also referred to as a vein that has reflux.
Inflammatory Skin Changes: Skin changes, usually in the lower leg and ankle, associated with long standing chronic venous insufficiency and frequently preceding venous ulcers.
Laser: A powerful beam of light that is used in some types of surgery to cut or destroy tissue. In endovenous ablation, it is used to direct energy very precisely to destroy the lining of veins and close them down.
Laser Ablation: A minimally invasive procedure delivers laser energy to the inside of the vein, which ultimately causes the diseased vein to seal off. Laser devices used in this procedure have frequencies that range from 810-1470 nm. The procedure is most often used to “close off” poorly functioning truncal veins of the lower extremity.
Leg: The part of the lower extremity below the knee.
Local Anesthesia: Local anesthesia involves numbing a specific part of the body to prevent feeling of pain during a procedure.
Lower Extremity: The entire lower limb, from the hip through the foot. In popular usage it is commonly referred to as the leg, although in medical terminology, the leg refers to the portion of the lower extremity from the knee to the foot.
Lymphedema: A condition of lymph fluid building up in the soft tissue. It may occur as a result of destruction, obstruction, or abnormal flow in the lymphatics, and may occur sporadically or as a consequence of surgery, injury, infection, or other precipitating event. Lymphedema is often distinguished from venous edema by physical examination. It is also classified according to age of onset, and may be inherited, acquired, or sporadic.
Micro-Phlebectomy: See Ambulatory Phlebectomy.
Mutation (with respect to Thrombophilia): An inherited condition affecting the clotting system which may result in a tendency to form clots.
Perforating Veins: Veins that connect the superficial and deep venous systems and usually perforate, or pierce the fascial layer.
Phlebectomy: See Ambulatory Phlebectomy.
Plethysmography: A testing method using a series of air cuffs which are inflated and deflated at set intervals to allow measurements of changes in blood flow. It is used infrequently in the assessment of chronic venous insufficiency.
Popliteal Vein: The deep vein located behind the knee.
Radiofrequency Ablation: A minimally invasive procedure that uses radiofrequency energy in bursts to provide heat to contract the collagen in the vein walls, causing them to collapse and seal off. It is used to “close off” poorly functioning veins of the lower extremity. It is also known by the proprietary name of “Closure” or “Venefit” procedure.
Reflux: The valves in the veins close just as blood begins to flow backwards. If the valves do not close properly, the blood , for a period of time, may flow backwards, or retrograde, resulting in high pressure in the system and potential damage to valves upstream, and setting up a cascade effect for more vein damage. The veins themselves may become tortuous and dilated varicose veins, and the tissues may suffer from high venous pressure.
Saphenous Vein: The great and small saphenous veins serve as the principal veins running superficially up the leg, eventually joining the deep vein system to return blood to the heart. The great saphenous vein goes fro the inside of the ankle all the way up to the groin. The small saphenous vein runs from the outside of the ankle and terminates in the space behind the knee. They are considered truncal veins of the superficial system.
Sclerosant: A chemical in liquid or foam form injected into a vein to destroy the lining cells and prompt the body to close down the vein.
Sclerotherapy: A simple procedure involves injecting a liquid or foam solution into the veins using a very fine needle. The chemical irritates the lining of the vein, causing it to scar down and fade away, as it is absorbed by the body. Blood flow shifts to nearby healthy veins. Sclerotherapy is used to treat varicose veins and spider veins.
SEPS: Subfascial Endoscopic Perforator Surgery is a videoscopic operative procedure used to treat incompetent perforator veins; those short veins that communicate between the deep and superficial vein systems. It is less invasive than older operations, but more invasive than percutaneous office based procedures. It may be useful in selected cases.
Small Saphenous Vein: Also known as Lesser Saphenous Vein (see Saphenous Vein).
Spider Veins: Spider veins are very small veins in or just under the skin which are not raised above the surface. They look like tiny branches or webs of blue, purple or red. Although spider veins may be associated with varicose veins and chronic venous insufficiency they may exist independently and treatment is usually considered cosmetic.
Stasis Dermatitis: See Inflammatory Skin Changes
Stripping: A surgical procedure to treat varicose veins. The abnormal saphenous vein is “stripped” from groin to lower leg by making an incision in each location, dissecting out the vein, ligating or tying it at each end, passing a flexible device through it, and avulsing the segment of vein. Tributaries, or branches, may be removed through a series of small incisions. This stripping method has been used since the 1950s but has largely been replaced by less invasive office procedures.
Superficial Thrombophlebitis: A blood clot with associated inflammation in a superficial vein. This condition can be very uncomfortable, but is usually not in and of itself, dangerous. However, it is often a sign of underlying venous insufficiency and also can be associated with concomitant deep vein thrombophlebitis, so it should prompt evaluation by a vein care expert.
Superficial Veins: Veins of the lower extremity that lie above the deep fascia and muscles, closer to the skin than deep veins. In the lower extremity, the saphenous veins are the main, or truncal, superficial veins.
Telangiectasia: The condition commonly known as spider veins.
Thigh: The part of the lower extremity above the knee.
Thrombophilia: A systemic condition, inherited or acquired, which makes one more likely to form clots.
Trivex Powered Phlebectomy: A method of stripping tributaries using fewer incisions, transillumination, tumescence, and a powered device to destroy affected non-truncal veins, usually performed in the operating room with anesthesia.
Truncal Veins: The major superficial veins of the lower extremity; great saphenous, accessory saphenous, and small saphenous veins
Tumescent Anesthesia: A technique used involving infiltration of large amounts of local anesthetic in the subcutaneous tissue. Its use in phlebology is different than when it may be used in cosmetic procedures such as liposuction. Dosages delivered for phlebology are under potentially toxic limits and the solution is precisely delivered around the vein to be treated, also acting as a heat sink during endovenous thermal ablations.
Varethena: A proprietary system using foam sclerotherapy to ablate truncal veins.
Varicose Veins: Bulging, weakened and tortuous or twisted veins primarily found in the lower extremity, or leg. These veins have lost their elasticity and contain ineffective valves. Blood pools and pressure builds up in these veins, leading to uncomfortable symptoms, swelling, and changes in surrounding tissues and skin.
Vein Valve: Healthy leg veins contain valves comprised of delicate flaps of tissue which open and close to promote flow towards the heart and prevent pressure from building up in the legs. They are designed to overcome the effect of gravity on the venous blood in the legs. Weakened, poorly functioning or destroyed valves are associated with varicose veins and chronic venous insufficiency.
Venefit: Formerly known as VNUS Closure, this minimally invasive procedure is similar to Laser Ablation for truncal veins, but uses radiofrequency energy to heat and shrink the affected vein in a controlled manner.
Venous Reflux: A term that describes what happens when the valves in the veins become weak or damaged and lose the ability to regulate the direction of blood flow. When blood “leaks” down past a bad valve, it is called reflux. Reflux allows blood to pool in the legs as opposed to moving upward toward the heart.
Venous Stasis Ulcer: If chronic venous insufficiency is left untreated, the skin may break down resulting in a wound in the leg. These ulcers usually appear near the ankles or lower leg and indicate a more severe and progressive state of disease. They may appear spontaneously or may follow seemingly minor trauma.